Chronic bacterial prostatitis: Difference between revisions
From IDWiki
(Created page with "== Background == === Microbiology === * Enterobacterales * Pseudomonas species * Occasionally, Enterococcus species == Clinical Manifestations == * Mild to mod...") Â |
(→â€) |
||
| Line 1: | Line 1: | ||
| − | == |
+ | ==Background== |
| − | === |
+ | ===Microbiology=== |
| − | * |
+ | *[[Enterobacterales]] |
| − | * |
+ | *[[Pseudomonas species]] |
| − | * |
+ | *Occasionally, [[Enterococcus species]] |
| − | == |
+ | ==Clinical Manifestations== |
| − | * |
+ | *Mild to moderate pelvic pain symptoms with recurrent [[Urinary tract infection|urinary tract infections]], typically with the same organism |
| − | * |
+ | *Prostate is usually normal on physical or endoscopic assessment |
| − | == |
+ | ==Diagnosis== |
| − | * |
+ | *The gold standard is the 4-glass test |
| − | ** |
+ | **Sample 1: first void (5-10 mL) |
| − | ** |
+ | **Sample 2: midstream |
| − | ** |
+ | **Sample 3: expressed prostatic secretions |
| − | ** |
+ | **Sample 4: first void after prostatic massage (5-10 mL) |
| − | ** |
+ | **Positive if sample 4 has ≥10 times the colony count of sample 1 |
| − | * |
+ | *Can also do 2-glass pre- and post-massage test |
| − | ** |
+ | **Sample 1: midstream urine (10 mL) |
| − | ** |
+ | **Sample 2: first void after prostate massage (10 mL) |
| − | ** |
+ | **Positive if sample 2 has ≥10 times the colony count of sample 1 |
| − | * |
+ | *Semen cultures are not recommended |
| − | * |
+ | *Prostatic ultrasonography is not recommended |
| − | == |
+ | ==Management== |
| − | * |
+ | *First-line treatment is [[fluoroquinolones]] for 4 to 6 weeks |
| − | * |
+ | *Alternatives include [[fosfomycin]] or [[TMP-SMX]] |
| − | * |
+ | *Acutely ill patients should be treated with a third-generation [[Cephalosporins|cephalosporin]] or [[Carbapenems|carbapenem]] |
[[Category:Genitourinary infections]] |
[[Category:Genitourinary infections]] |
||
Revision as of 14:20, 14 September 2020
Background
Microbiology
- Enterobacterales
- Pseudomonas species
- Occasionally, Enterococcus species
Clinical Manifestations
- Mild to moderate pelvic pain symptoms with recurrent urinary tract infections, typically with the same organism
- Prostate is usually normal on physical or endoscopic assessment
Diagnosis
- The gold standard is the 4-glass test
- Sample 1: first void (5-10 mL)
- Sample 2: midstream
- Sample 3: expressed prostatic secretions
- Sample 4: first void after prostatic massage (5-10 mL)
- Positive if sample 4 has ≥10 times the colony count of sample 1
- Can also do 2-glass pre- and post-massage test
- Sample 1: midstream urine (10 mL)
- Sample 2: first void after prostate massage (10 mL)
- Positive if sample 2 has ≥10 times the colony count of sample 1
- Semen cultures are not recommended
- Prostatic ultrasonography is not recommended
Management
- First-line treatment is fluoroquinolones for 4 to 6 weeks
- Alternatives include fosfomycin or TMP-SMX
- Acutely ill patients should be treated with a third-generation cephalosporin or carbapenem
